Assessing Efficacy of Antiviral Therapy for COVID-19 Patients: A Case Study on Remdesivir with Bayesian Synthesis Design and Multistate Analysis
Liao et al.
, Assessing Efficacy of Antiviral Therapy for COVID-19 Patients: A Case Study on Remdesivir with Bayesian..
, Journal of the Formosan Medical Association, doi:10.1016/j.jfma.2021.04.026 (meta analysis)
Bayesian synthesis design and multistate analysis of remdesivir results showing 31% [18-44%] lower risk of death and 10% [1-18%] higher recovery.
Currently there are 48 remdesivir studies
and meta analysis shows:
Liao et al., 4 May 2021, peer-reviewed, 7 authors.
Abstract: Journal of the Formosan Medical Association 120 (2021) S77eS85
Available online at www.sciencedirect.com
journal homepage: www.jfma-online.com
Assessing efficacy of antiviral therapy for
COVID-19 patients: A case study on
remdesivir with bayesian synthesis design
and multistate analysis
Sih-Han Liao a,b,c, Chien-Ching Hung d,e, Chiung-Nien Chen f,g,
Jui-Yi Yen h, Chen-Yang Hsu a,i, Amy Ming-Fang Yen j,
Chi-Ling Chen a,g,k,*
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan
University, Taipei, Taiwan
Section of Gastroenterology, Department of Medicine, National Taiwan University Cancer Center,
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan
University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan
University College of Medicine, Taipei, Taiwan
Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine,
Center for Functional Image and Interventional Therapy, National Taiwan University, Taipei, Taiwan
Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan
Dachung Hospital, Miaoli, Taiwan
School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei,
Received 6 April 2021; received in revised form 18 April 2021; accepted 21 April 2021
Background/purpose: A synthesis design and multistate analysis is required for assessing the
clinical efficacy of antiviral therapy on dynamics of multistate disease progression and in
reducing the mortality and enhancing the recovery of patients with COVID-19. A case study
on remdesivir was illustrated for the clinical application of such a novel design and analysis.
Methods: A Bayesian synthesis design was applied to integrating the empirical evidence on the
one-arm compassion study and the two-arm ACTT-1 trial for COVID-19 patients treated with
* Corresponding author. Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, 7 Chung-Shan South
Road, Taipei, 100, Taiwan. Fax: þ886 2 23709820.
E-mail address: email@example.com (C.-L. Chen).
0929-6646/Copyright ª 2021, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC
BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
S.-H. Liao, C.-C. Hung, C.-N. Chen et al.
remdesivir. A multistate model was developed to model the dynamics of hospitalized COVID-19
patients from three transient states of low, medium-, and high-risk until the two outcomes of
recovery and death. The outcome measures for clinical efficacy comprised high-risk state,
death, and discharge.
Results: The efficacy of remdesivir in reducing the risk of death and enhancing the odds of recovery were estimated as 31% (95% CI, 18e44%) and 10% (95% CI, 1e18%), respectively. Remdesivir therapy for patients with low-risk state showed the efficacy in reducing subsequent
progression to high-risk..
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